br Methods This was a retrospective review of hospital
Methods This was a retrospective review of hospital records of dental patients who were treated under GA from January 2006 until November 2015. All participants who attended our hospital were first examined to evaluate their behavioral capabilities and their psychological and physical disabilities. Qualified pediatric dentists performed charting and an oral examination. The behavior of patients was then classified according to Wright\'s Clinical Classification (1975). Indications for the use of GA are based on specific criteria that take into account the risks, benefits, effectiveness, anticipated outcomes, and the use of other behavior management techniques as an alternative. These criteria are listed in Table 1. If the guardian of the uncooperative child is hesitant to allow the use of GA, the patient then still undergoes dental treatment; this protein phosphatase inhibitor being arranged on an outpatient department basis initially. Several appointments take place involving behavior guidance, including regulation, tell–show–do, and desensitization, which are combined with oral hygiene instruction and intensive fluoride application for caries control. If the patient still fails to respond, GA may be recommended. Prior to the dental treatment procedures under GA, appropriate pediatric physicians and anesthesiologists are consulted on the systemic condition of each participant in order to ensure there are no absolute contraindications for the GA that is to be performed. The following dataset was collected for each participant: age (< 3 years, 3–6 years, and > 6 years), sex, medical diagnosis, caries status, types and numbers of treatments, and any complications. Caries status was recorded based on the World Health Organization oral health survey criteria and methods, which use the decayed, extracted, and filled surface (DEFS) index for primary dentition and the decayed, missing, and filled surface (DMFS) index for permanent dentition. In cases of mixed dentition, the two indices were combined to assess the caries status. The types of dental treatment identified consisted of restoration, pulp therapy, and extraction. The inclusion criterion for patients was that the patient had received comprehensive dental treatment under GA, which resulted in a total of 1126 cases. The exclusion criterion was that the patient had incomplete longitudinal records. Using the records from the hospital database, 792 cases were identified with complete records and these records were then retrieved.
Results Among 791 participants, there were 549 boys and 242 girls enrolled in our study. The mean age of the enrolled patients was 5.77±3.55 years. In terms of age, 65 patients were aged < 3 years old, 235 patients were 3–6 years old, and 235 patients were > 6 years old. The case number was found to have increased from 94 during 2006–2007 to 238 during 2014–2015; semiconservative replication increase was especially pronounced for the 3–6-years-old group, which during 2006–2007 consisted of 49 patients and during 2014–2015 consisted of 165 patients. The mean ages and sex ratios of the three groups remained almost the same over this 10-year period. Details are shown in Table 2. The most common treatments, including extraction, restoration, and pulp therapy, were for multiple dental caries. This group consisted of 684 of the total of 791 patients (86.4%). The other major indication for pediatric dentistry under GA was a need for surgery, which included surgical odontectomy (12.4%), enucleation (0.7%), surgical exposure (0.4%), and biopsy (0.1%) (Table 3). The overall mean DEFS/DMFS index was 27.80±20.60. The DEFS/DMFS index was significantly higher among the < 3-years-old patients (39.98±18.10) than among the 3–6-years-old patients (31.46±20.78) and the > 6-years-old patients (17.18±16.38). The overall mean number of treated teeth was 16.79±8.95. The mean number of treated teeth in the three groups was significantly higher in the < 3-years-old group (16.34±40), which was followed by the 3–6-years-old group (13.37±5.39) and then the > 6-years-old group (9.09±6.18). Details are shown in Table 4.